Birth options with twins

[TheWayTheLightFalls]

I’m nearly 30w now with fraternal twins and having a really hard time reaching any sort of conclusion about birth options.

DC1 was a vaginal delivery, spontaneous labour, episiotomy. I got through most of labour at home and turned up to hospital fully dilated. Things then stalled, nothing much happened for 10 hours, I was exhausted and put on a drip to get things going again, she made an entrance as they were considering further intervention.

These two are currently both breech. The one nearest the exit (whose position determines whether a VB is possible at all) sometimes flips; the other has been breech for months.

I’m really put off by the idea that even the lowest-intervention twin birth is going to be in theatre, on my back, with an epidural (that’s what they recommend), with about 15 people in the room. Those are all things really not conducive to my being able to push these babies out with minimal intervention, imo.

On the other hand I think recovery from a straightforward VB (if I have one) will be easier than from a ELCS let alone an EMCS.

At the moment I'm thinking:

• If T1 is breech and I go into spontaneous labour before 37w, it'll have to be a CS.
• If T1 is head-down and I go into spontaneous labour before 37w, try for a VB.
• If I go over 37w (full term for this type of twin), request an elective. Or perhaps agree to, say, the first stage of an induction if things are looking favourable?

I've no idea really. A part of me is thinking "Fuck it, there are two babies in there, book a section and stop faffing around". WWYD? Or if you've been there, what motivated your choices?

I'd also add, I am huge and uncomfortable with bad SPD, breathing difficulties etc, none of which I had with DD. So I can't vouch for my stamina in getting through a VB, either.

I had my fraternal twins by c section. Always had a c section because both were breech and were from around 24 weeks. They never turned. The advice from the consultant was to have a csection because they were both breech.

I probably would have tried for a vaginal birth if T1 had been head down, though I have no comparison because they are my first children.

Their birth ended up being very traumatic. Thought my waters had broken at 36+5, 3 days before planned c section. It was all blood. Rushed to hospital by ambulance and they were born within 2 hours or so. In hindsight, it wasn’t as bad as I thought it was at the time but one of the placentas had started to abrupt.

Babies are often breech at this stage, I wouldn't panic about that yet. Obviously it's tricker with twins as less room, but have a go at the stuff on spinning babies website to turn them.

I was birth partner for my friend's twin birth. She is disabled and had a previous CS then a VBAC, but birthed both twins vaginally. That's what are wanted. The midwife said she'd never seen a second twin birthed vaginally so the professionals aren't always the people to listen to as they don't always have much vaginal twin experience, in the same way they often don't have vaginal breech experience.

Decide what you want, talk it through with them, look into all your options and be prepared to be flexible as your birth progresses too. It's never predictable and all birth is valid and beautiful.

I had fraternal twins vaginally at just over 37 weeks. I had a previous vaginal birth with my first which sounds almost identical to yours, except I needed ventouse in the end. My twin birth was far quicker and far easier. I was induced at 37+1, both had just turned to head down. 9 hour labour, just with a midwife (no theatre), epidural after a few hours. Midwife delivered both babies with registrar and extra midwife in room but not loads of people. 2nd twin was in a funny position but midwife assisted. I think I was probably lucky it was so straightforward but I was keen to avoid section if I could with older one at home. Obviously babies position makes the most difference though. Good luck, twins are awesome!

I had twins VB. twin A was head down twin b was breech and had been for months. I was induced at 36 weeks with a Pessary didn’t need a drip, early epidural they tried to turn the second twin but she was born breech.it was all really calm and relaxed actually. Sudden influx of doctors for the birth but me, ex, student doctor and midwife for most of it. My previous labours, two, were really fast back to back contractions, pain and lots of vomiting. Much preferred this one. I know 5% of vb twins end in a crash c section for the second twin though. I know another twin mum who this happened to, children were fine though.

Thanks all. Lots to think about! For the moment I suspect both are head up -and standing on my bladder - let's see what the next few weeks bring.

I had a c-section with my twins. DT1 was breech and also had IUGR. It was a really lovely experience. I was completely pain free and lucid.

Had a Vbac with DC3 and wish I’d gone for a section again!

I had my fraternal twins at just over 37 weeks via induction and epidural. I went into active labour extremely quickly and was told I had to push as no one was available to perform the epidural. After over an hour of pushing they became available and I had my epidural and delivered both with forceps. They are my only children so also nothing to compare it to. What I would say though is prepare yourself to go with the flow as plans change so quickly, especially with twins. I naively thought as my consultant had expressway told me I should have an epidural early for the safety of the second twin that this is what would happen. I didn’t even factor in the possibility of a plan B and this made the situation far more stressful for me when things didn’t go to plan. Congratulations twins are fab!

I had twins @ 31 weeks. The second was breech. I wanted a waterbirth, candles blah blah but listened to the experts and went for an epidural as they were prem and not robust for pushing, I was told. It was an unusual event at this hospital and I was asked if I minded if trainees observed (no) so ended up, naked, with 22 strangers in the room, all trying to be discreet and not look, but still look! But I didn't care. I had a brilliant experienced midwife who turned the second baby once the first was born. They came 19 mins apart and actually before the epidural had taken effect. It wasn't the hippy birth I'd planned and would've done it differently if one baby/full term but I've no regrets about it. I did struggle while the babes were in SCBU. Took a few days for my milk to come in and they had to be given formula at first but me being bloody minded and determined to bf, pumping like mad for several weeks got me through! Best wishes, OP.

No twin experiences to contribute at all but just wanted to say I have an elective section on Monday and the recovery has been so much better than I imagined! Day 5 and I have been out today for a short while and plan to go a short walk tomorrow. I feel almost normal, the only thing I can’t do is go from lying down in bed to sitting up. I am taking everything very slowly but really expected it to be an awful lot worse than it has been! I have had very little pain whatsoever. I am still keeping on top of painkillers but haven’t felt uncomfortable at all! Weigh up your options and see the pros and cons for each but just wanted to give a positive c-section view 😊